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A TEACHABLE MOMENT – THE MANY FACES OF SULCUS THRUSH – (and how it can go sideways.)

This is worth a few moments of any horseperson’s time.
We received an email today from a good customer we had spoken to in the past. She provided pics The quick backstory is that Mrs. C is from B.C. Canada and late in January, she bought NO THRUSH Powder (AKA: NT DRY in Canada) to use on 4 horses with significant sulcus thrush.
Her email today said that she had great success on all the horses, except had trouble with one foot. It wouldn’t seem to firm up the way the others did. Then a few days ago she was cleaning feet and suddenly her pick dropped down into and created the hole in the sulcus that you see in the photos. It was bleeding and messy. She determined it was not a blown abscess, and asked for advice on what we thought this was and if she could use her NO THRUSH Powder to treat it.
This letter below will take you through the entire process with a Plan A as well as backup plan A.2 (if necessary.)
CLARITY NOTE: The before/after photo in the pics is not Mrs. C’s horse. This is the photo that I sent to her and which I mention in my response below.
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“Good Morning Mrs. C:
“The short answer is:
Yes, you can use NT Dry for this issue. The fact that you can’t get this heel/frog firmed up using NT over these 4 months means that there is definitely an infection inside/underneath the tissue.
Long answer:
I looked back at our emails from January and reviewed the pics from back then. Those pics showed a typical thrush-created split between the heel bulbs. Now the horse has no heel crack. It appears that what has happened is that one of those old heel cracks closed up and encased a pocket of thrush…. FYI; When I’m doing customer demonstrations I show folks how to be quite aggressive when getting NT powder into the sulcus crack. I will wiggle my hoofpick side-to-side and really manipulate the tissue. The idea is to allow the tissue to regrow from the bottom, but not let it prematurely close from the top. This overgrowth is not normally a problem, but it happens. I’m sorry that I didn’t mention this protocol to you when we last spoke.
I’m guessing the thrush pocket has been active for a while, which is why the sulcus is now detaching from the frog (the area you circled in yellow.) Now it has finally made it to the surface and “suddenly” appeared.
So, to the point… If this was my horse, this is what I’d do:
** Do a good clean of the foot. Since you already did an Epson salt soak, and you feel that it doesn’t appear to be an abscess, I wouldn’t do more soaking or washing. This will just give the bacteria the moisture it needs to thrive.
** Use your NT powder and puff it into the hole/opening of the wound, and really work it into the cracks around the detaching sulcus area. (Be sure to also use it in the clefts around the frog). and then Scrub it in with a stiff hoof brush
.
** Add a little more powder on top and then do the same duct tape process you were doing. I like to add some cotton batting between the foot and tape to ensure the powder pops around in there all day long. If possible, change this every day for several days.
** The goal is to “Draw out”, “Dry up” and “Firm Up” as quickly as possible.
** In the ideal world, this process will draw out all the bacteria that was exposed when that hole opened up, and full regrowth will occur (20-50 days) to become the dimple we are looking for.
The potential concern would be that the bacteria pocket has expanded throughout the interior parts of the frog. So…. if in a few weeks you don’t feel that the frog/heel is firming up as it did with all your other horses, we may have to go to plan A.2
In that case, here is what I would do to be proactive…….
** After several days of doing the NT / Duct tape, when the frog has firmed up a bit, I’d get my farrier in and start slowly trimming away the detached sulcus. That tissue is trying very hard to become necrotic and his body will ultimately shed it. You will just be helping it along.
** NOTE: I have attached a before/after pic so you can see what I mean about trimming away the necrotic tissue. In the “After” picture, the sulcus looks dished out and has become a “dimple.”
** Continue the NT process. Really, really get the powder into all those little cracks in the sulcus tissue. (At some point when everything is very firm you can stop the duct tape wrapping.. But stay steady with the dusting.
** You or your trimmer keep paring down the sulcus whenever you can. At some point you will hit the pocket of ingrown infection and can dust it directly with NT.
** Keep dusting until the hole/wound becomes a dimple and is completely covered with hide.
** After that, I suggest keeping up a preventative NT dusting a few times a week, since we know this horse is prone to thrush and infection.
Long-winded there! Hope this helps, Mrs. C. Call any time I can help.”
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